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Abstract Objective To analyzes the correlation between the Western Ontario and McMaster universities (WOMAC) arthritis index，coronary lower limb force line angle，and lumbar biomechanical factors in knee osteoarthritis (KOA) patients，providing new ideas for clinical diagnosis and treatment of KOA.Methods 267 KOA patients who visited the Department of Orthopedics and Traumatology at the First Affiliated Hospital of Hebei University of Chinese Medicine from October 2022 to May 2023 and met the inclusion criteria were selected.This group included 49 males and 218 females，aged 50~83 years，with an average age of (61.55±8.72)years old.X-rays of the lumbar spine combined with the full length of both lower limbs in a weight-bearing position were taken.The direction of lumbosacral deviation was observed，and the force line angle of the lower limbs in a coronal position was measured：hip-knee-ankle angle (HKA)，mechanical axis deviation (MAD)，joint line convergence angle (JLCA).Lumbar biomechanical factors were also measured：lumbosacral offset distance (LOD)，waist-knee offset distance (WKOD).The WOMAC score and baseline data of the subjects were recorded to analyze their differences.The correlation between coronal force line angle and lumbar biomechanical factors was then evaluated.Results There is a correlation between the direction of lumbosacral deviation and the severity of KOA pain (P＜0.05，r＝0.569).Furthermore，there is a correlation between LOD，WKOD，HKA，MAD，JLCA，disease duration，and WOMAC score (P＜0.05，r values are 0.585，0.579，－0.156，0.173，0.175，0.189，respectively).Conclusion There is a correlation between joint pain and functional limitation in KOA patients and the shift of the lumbar center of gravity and lower limb force line angle.The degree of joint stiffness in KOA patients is correlated with the duration of the disease，and the shift of the lumbar coronal center of gravity is one of the risk factors for inducing or exacerbating KOA.
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［1］Wang M，Liu L，Zhang CS，et al.Mechanism of traditional chinese medicine in treating knee osteoarthritis［J］.J Pain Res，2020(13)：1421-1429.
［2］Wu SY，Lin CH，Chang NJ，et al.Combined effect of laser acupuncture and electroacupuncture in knee osteoarthritis patients：A protocol for a randomizedcontrolled trial［J］.Medicine (Baltimore)，2020，99(12)：E19541.
［3］Wang TQ，Li LR，Tan CX，et al.Effect of electroacupuncture on gut microbiota in participants with knee osteoarthritis［J］.Front Cell Infect Microbiol，2021(11)：597431.
［4］Wang Z，Efferth T，Hua X，et al.Medicinal plants and their secondary metabolites in alleviating knee osteoarthritis：A systematic review［J］.Phytomedicine，2022(105)：154347.
［5］Li R，Chen H，Feng J，et al.Effectiveness of traditional chinese exercise for symptoms of knee osteoarthritis：A systematic review and meta-analysis of randomized controlled trials［J］.Int J Environ Res Public Health，2020，17(21)：7873.
［6］Iwamura Y，Inasaka R，Fujimaki H，et al.Clinical and radiological features of lumbar degenerative spondylolisthesis who complicates osteoarthritis of the knee［J］.J Orthop Sci，2020，25(5)：800-804.
［7］Kim HJ，Chun HJ，Han CD，et al.The risk assessment of a fall in patients with lumbar spinal stenosis［J］.Spine (Phila Pa 1976)，2011，36(9)：E588-592.
［8］中华医学会骨科学分会关节外科学组.骨关节炎诊疗指南(2018年版)［J］.中华骨科杂志，2018，38(12)：705-715.
［9］Kellgren JH，Lawrence JS.Radiological assessment of osteo-arthrosis［J］.Ann Rheum Dis，1957，16(4)：494-502.
［10］Pan S，Huang C，Zhang X，et al.Non-weight-bearing short knee radiographs to evaluate coronal alignment before total knee arthroplasty［J］.Quant Imaging Med Surg，2022，12 (2)：1214-1222.
［11］Copsey B，Thompson JY，Vadher K，et al.Problems persist in reporting of methods and results for the WOMAC measure in hip and knee osteoarthritis trials［J］.Qual Life Res，2019，28(2)：335-343.
［12］刘飞，王渭君，邱勇，等.髋关节疾病患者脊柱-骨盆-下肢矢状面形态异常的研究进展［J］.中国矫形外科杂志，2014，22(13)：1195-1198.
［13］李潇.膝关节骨关节炎患者胫骨股骨扭转角与下肢力线间的相关性分析［D］.长春：吉林大学，2023.
［14］Obeid I，Hauger O，Aunoble S，et al.Global analysis of sagittal spinal alignment in major deformities：Correlation between lack of lumbar lordosis and flexion of the knee［J］.European Spine Journal，2011，20(s5)：681-685.
［15］Murata Y，Takahashi K，Yamagata M.The knee-spine syndrome.Association between lumbar lordosis and extension of the knee［J］.J Bone Joint Surg (Br)，2003，85(1)：95-99.
［16］〖JP3〗黄少敏，赵宇.膝骨关节炎与腰椎退行性疾病发病关系的研究进展［J］.中国骨与关节外科，2013，6(1)：87-89.〖JP〗
［17］Suri P，Morgenroth DC，Kwoh CK，et al.Low back pain and other musculoskeletal pain comorbidities in individuals with symptomatic osteoarthritis of the knee：data from the osteoarthritis initiative［J］.Arthrit Care Res，2010，62 (12)：1715-1723.
［18］Iijima H，Suzuki Y，Aoyama T，et al.Interaction between low back pain and knee pain contributes to disability level in individuals with knee osteoarthritis：A cross-sectional study［J］.Osteoarthr Cartilage，2018，26 (10)：1319-1325.
［19］Izzo R，Guarnieri G，Guglielmi G，et al.Biomechanics of the spine.Part Ⅰ：Spinal stability［J］.European Journal of Radiology，2013，82(1)：118-126.
［20］Granata KP，Gottipati P.Fatigue influences the dynamic stability of the torso［J］.Ergonomics，2008，51(8)：1258-1271.
［21］Omori G，Koga Y，Tanaka M，et al.Quadriceps muscle strength and its relationship to radiographic knee osteoarthri-tis in Japanese elderly［J］.J Orthop Sci，2013，18(4)：536-542.
［22］Malahias MA，Gu A，Richardson SS，et al.Association of lumbar degenerative disease and revision rate following total knee arthroplasty［J］.J Knee Surg，2020，34(10)：1126-1132.
［23］鲁洋.内侧间室型膝骨关节炎股骨形态学变化及其对截骨矫形手术决策与疗效影响的三维有限元分析［D］.石家庄：河北医科大学，2021.
［24］师宁宁，沈国权，何水勇，等.髂骨旋转移位与L4~5椎间盘退变之间的相关性生物力学分析［J］.中国骨伤，2016，29(5)：439-443.
［25］Hunt MA，Mcmanus FJ，Hinman RS，et al.Predictors of single-leg standing balance in individuals with medial knee osteoarthritis［J］.Arthritis Care Res，2010，62(4)：496-500.
［26］Bennell KL，Dobson F，Roos EM，et al.The influence of biomechanical characteristics on pain and function outcomes from exercise in medial knee osteoarthritis and varus malalignment：Exploratory analyses from a randomised controlled trial［J］.Arthritis Care Res，2015，67(9)：1281-1288. |
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